Toward HLA Epitope Matching in Clinical Transplantation

Nowadays immunological graft rejection is often associated with the development of de novo donor-specific antibodies (DSA), which may be an important reason why fully matched grafts do so well since patients will not form DSA against their donors’ HLA-matched antigens. Although on the population level an association can be found between the number of HLA antigen mismatches and the chance that patients will develop DSA (2), it is still currently impossible to predict whether a specific HLA mismatch will induce antibodies in an individual patient.